Survival benefits of extensive surgery in patients with papillary thyroid microcarcinoma - 26/02/24
, Emad Kandil b, ⁎ Abstract |
Background |
Despite the guidelines recommending thyroid lobectomy, many papillary thyroid microcarcinoma (PTMC) patients still undergo total thyroidectomy. PTMC's optimal treatment remains unclear. We aimed to determine whether total thyroidectomy improves outcomes compared to less extensive surgery.
Methods |
We analyzed 6064 PTMC adult patients from the Surveillance, Epidemiology, and End Results (SEER) database (2000–2019) who underwent either total thyroidectomy (n = 3652) or less extensive surgery (n = 2412). Endpoints were overall survival, cancer-specific survival, and recurrence.
Results |
Total thyroidectomy patients had a 5.2 % mortality rate versus 8.1 % with less extensive surgery. Recurrence occurred in 1 (0.03 %) total thyroidectomy patient compared to 24 (1.0 %) less extensive surgery patients (HR 0.07, p = 0.01). Median survival was 8.1 years for total thyroidectomy versus 8.8 years for less extensive surgery. Overall survival favored total thyroidectomy (p = 0.001) but cancer-specific survival did not differ.
Conclusion |
Although total thyroidectomy may not improve cancer-specific survival, it lowers recurrence risk and confers an overall survival advantage for PTMC patients. These findings may help guide surgical decisions.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Patients with PTMC who underwent extensive surgery exhibited lower recurrence rates than less extensive surgery patients. |
• | Extensive surgery showed a better overall survival than less extensive surgery. |
• | Extensive surgery should be considered for patients with PTMC. |
Keywords : Thyroid cancer treatment guidelines, Cancer databases, Cancer survival rate, Surgical procedure, Patient outcomes
Plan
Vol 229
P. 99-105 - mars 2024 Retour au numéro
Article précédent
- Pancreatic stump closure after distal pancreatectomy: Systematic review and meta-analysis of randomized clinical trials comparing non-autologous versus no reinforcement: Value of prediction intervals
- Mohamed Ali Chaouch, Chadli Dziri, Selman Uranues, Abe Fingerhut
- ATA risk stratification in papillary thyroid microcarcinoma has low positive predictive value when identifying recurrence
- Andy Tran, Ronald J. Weigel, Anna C. Beck
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?